Jessy S. Sidhu, DMD Prof. Corp.

Primary specialty

DentistTaxonomy code 122300000X

License

48549 Issued in CA

Legal business name

JESSY S. SIDHU, DMD PROF. CORP.

Practice address

12925 El Camino Real Ste J22
San Diego, CA 92130-1893

Phone

(858) 350-1005

Fax

(858) 350-1004

NPI assigned

Jan 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jessy Singh Sidhu, DMD

Title

President

Phone

(702) 860-7600

Specialties & licenses 1

Addresses

Other names 1

• Del Mar Highlands Dentistry Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392249600000",
    "number": "1750448650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12925 EL CAMINO REAL STE J22",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921301893",
            "telephone_number": "858-350-1005",
            "fax_number": "858-350-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12925 EL CAMINO REAL STE J22",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921301893",
            "telephone_number": "858-350-1005",
            "fax_number": "858-350-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSY S. SIDHU, DMD PROF. CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2014-02-13",
        "status": "A",
        "authorized_official_last_name": "SIDHU",
        "authorized_official_first_name": "JESSY",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "702-860-7600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "48549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Del Mar Highlands Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.